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SB1710 - 572R - I Ver
REFERENCE TITLE:
pharmacy benefits; patient steering; prohibition
State of Arizona
Senate
Fifty-seventh Legislature
Second Regular Session
2026
SB 1710
Introduced by
Senator
Shamp
AN
ACT
amending title 20, chapter 25, article 2,
arizona revised statutes, by adding sections 20-3337, 20-3338 and
20-3339; relating to pharmacy benefit managers.
(TEXT OF BILL BEGINS ON NEXT PAGE)
Be it enacted by the Legislature of the State of Arizona:
Section 1. Title 20, chapter 25, article 2,
Arizona Revised Statutes, is amended by adding sections 20-3337, 20-3338 and 20-3339,
to read:
START_STATUTE
20-3337.
Pharmacy benefit managers; affiliated providers; prohibition
against steering; definition
A. A pharmacy benefit manager may not
transfer to or receive from its affiliated provider a record that contains
patient or prescriber identifiable prescription information for a commercial
purpose.� For the purposes of this subsection, commercial purpose does not
include pharmacy reimbursement, formulary compliance, pharmaceutical care,
utilization review by a health care provider or a public health activity
authorized by law.
B. A pharmacy benefit manager may not
directly or indirectly steer a patient to use the pharmacy benefit manager's
affiliated provider by doing any of the following:
1. Communicating through data mining
or other similar processes of patient information that are generated from or
obtained through the prescription filling process at a pharmacy, including:
(
a
) Contacting
the patient verbally or in writing to influence the patient directly or
indirectly.
(
b
) Providing a
patient with the option to use an alternative pharmacy that is a pharmacy
benefit manager's affiliated provider.
2. Attempting to influence a patient
to use an affiliated provider.
3. Retaliating against a patient who
does not use an affiliated provider.
C. Subsection B of this section does
not prevent a pharmacy benefit manager from including its affiliated provider
in a patient or prospective patient communication if the communication both:
1. Regards information about the cost
or service provided by pharmacies or durable medical equipment providers in the
network of a health benefits plan in which the patient or prospective patient
is enrolled.
2. Includes accurate comparable
information regarding pharmacies or durable medical equipment providers in the
network that are not the issuer's or pharmacy benefit manager's affiliated
providers.
D. A pharmacy benefit manager may not
do any of the following:
1. Penalize a beneficiary or provide
an inducement to the beneficiary for the purposes of getting the beneficiary to
use a specific retail, mail order or other network pharmacy that is the
pharmacy benefit manager's affiliated provider. For the purposes of
this paragraph, "inducement" means providing financial incentives,
including variations in premiums, deductibles, copayments or coinsurance.
2. Solicit a patient or prescriber to
transfer a patient prescription to the pharmacy benefit manager's affiliated
provider.
3. Require a pharmacy or durable
medical equipment provider that is not the pharmacy benefit manager's
affiliated provider to transfer a patient's prescription to the pharmacy
benefit manager's affiliated provider without the prior written consent of the
patient.� This paragraph does not prohibit a patient from personally requesting
to transfer the patient's prescription without written consent.
4. Pay an affiliated provider a
reimbursement amount that is more than the amount the pharmacy benefit manager
pays a pharmacy or durable medical equipment provider that is not an affiliated
provider for the same product or service.
5. Commit any unfair and deceptive
trade practice that is prohibited by section 44-1522.
E. The prohibitions in this section
apply to a pharmacy benefit manager acting on its own behalf or on behalf of an
insurer.
F. This section does not apply to
health and accident insurance coverage that is obtained by the department of
administration under section 38-651.
G. The department may investigate
violations of this section. Any conduct in violation of this section that is
performed with such a frequency as to indicate a general business practice
constitutes an unlawful practice under section 44-1522 and is subject to
the consumer fraud provisions under title 44, chapter 10, article 7.
H. For the purposes of this section,
"affiliated provider" means a pharmacy or durable medical equipment
provider that directly, or indirectly through one or more intermediaries,
controls, is controlled by or under common control with a pharmacy benefit
manager.
END_STATUTE
START_STATUTE
20-3338.
Clinician-administered drugs; limitations; definitions
A. A pharmacy benefit manager or a
health insurer may not:
1. Require a clinician-administered
drug to be dispensed by a pharmacy, including by an affiliated provider, as a
condition of coverage.
2. Limit or exclude coverage for a
clinician-administered drug or prescription drug that is not dispensed by
a pharmacy or affiliated provider, if the prescription drug is otherwise
covered under the health benefit plan or pharmacy benefit plan.
3. Cover a prescription drug as a
different benefit or tier or with cost sharing requirements that impose greater
expense for a covered individual if the drug is dispensed or administered at
the prescriber's office, a hospital outpatient infusion center or any other
outpatient clinical setting rather than a pharmacy or affiliated provider.
4. Commit any unfair and deceptive
trade practice that is prohibited by section 44-1522.
B. This section does not do either of
the following:
1. Authorize a person to administer a
prescription drug that is otherwise prohibited under the laws of this state or
federal law.
2. Modify prescription drug
administration requirements under the laws of this state, including any
requirements related to delegating and supervising prescription drug
administration.
C. The department may investigate
violations of this section.� Any conduct in violation of this section that is
performed with such a frequency as to indicate a general business practice
constitutes an unlawful practice under section 44-1522 and is subject to
the consumer fraud provisions under title 44, chapter 10, article 7.
D. This section does not apply to
health and accident insurance coverage that is obtained by the department of
administration under section 38-651.
E. For the purposes of this section:
1. "Affiliated provider"
has the same meaning prescribed in section 20-3337.
2. "Clinician-administered
drug" means an outpatient prescription drug that cannot reasonably be self-administered
by the patient to whom the drug is prescribed and that is typically
administered by a health care provider authorized under the laws of this state
to administer the drug.
3. "Health care provider"
means an individual who is licensed, certified or otherwise authorized to
provide health care services in this state.
4. "Prescriber" means an
individual who is licensed to prescribe prescription drugs in this state.
END_STATUTE
START_STATUTE
20-3339.
Pharmacy benefit managers; transparency annual report; department
A. On or
before March 1, 2027 and each year thereafter, a pharmacy benefit manager, as a
condition of licensure, shall submit a transparency report to the department
that includes the following data from the prior calendar year:
1. The
amount of all rebates that the pharmacy benefit manager received from
pharmaceutical manufacturers.
2. The
total amount of all administrative fees that the pharmacy benefit manager
received.
3. The
amount of all negotiated price concessions, including base price concessions,
reasonable estimates or any price protection rebates not including manufacturer
rebates and performance-based concessions.
4. The
total amount of all rebates that were passed to enrollees at the point of sale
of a prescription drug.
5. The
total amount of all reimbursements that were paid to network pharmacies in this
state, specifically identified as a local pharmacy, an affiliated pharmacy and
a nonaffiliated pharmacy.
6. The
total amount of all specialty drug rebates that the pharmacy benefit manager
received.
7. The total number of other services that were provided by
the pharmacy benefit manager or its affiliates or subsidiaries in addition to
prescription drugs, including the identification of the services provided, the
cost of the services provided and where the services were provided.
8. The
complete corporate vertical integration structure of all components related to
the pharmacy benefit manager, including the insurer, pharmacy benefit manager,
group purchasing organization, manufacturer, wholesale distributor, specialty or
mail order pharmacy, retail or long-term care pharmacy and provider.
B. The
transparency report shall:
1. Categorize
the data by each pharmacy benefit manager's CONTRACTUAL or other relationship
with a health benefit plan or a health insurer.
2. Be
made available on request to the public in a form that does not disclose any of
the following:
(
a
) The identity of a specific health benefit plan.
(
b
) The prices that were charged for specific drugs or
classes of drugs.
(
c
) Any rebates that were provided for specific drugs or
classes of drugs.
END_STATUTE
Sec. 2.
Applicability
Sections 20-3337, 20-3338
and 22-3339, Arizona Revised Statutes, as added by this act, apply to
contracts that are entered into, amended, extended or renewed on or after the
effective date of this act.